Can locally advanced prostate cancer undergo radical surgery?

For localized prostate cancer, radical prostatectomy is the most effective treatment, but there is still controversy as to whether radical prostatectomy can be performed for clinically locally advanced prostate cancer without distant metastasis.

It is generally believed that radical prostatectomy cannot completely control locally advanced prostate cancer, nor can it improve the long-term survival of these patients. However, clinical observations over the years have shown that approximately 25% of patients with locally advanced prostate cancer are actually T2 (i.e., localized prostate cancer). However, there are many patients with clinically locally advanced prostate cancer who survive long-term after radical prostatectomy. At the prostate cancer symposium of the 18th National Urology Academic Conference on October 29, 2011, urology experts from Europe and China had extensive discussions on new perspectives on the treatment of clinically locally advanced prostate cancer, as well as the new content in the 2011 European Prostate Cancer Diagnosis and Treatment Guidelines and the 2011 Chinese Prostate Cancer Diagnosis and Treatment Guidelines, and agreed that radical prostatectomy can be chosen for clinically locally advanced prostate cancer.

Clinical scholars have followed up on some prostate cancer patients who had been treated and found that patients who were diagnosed with very advanced disease and almost inoperable at the time did not show any signs of metastasis through bone scans. After endocrine therapy, the prostate volume shrank and PSA dropped to a very low level, but nodules could still be felt in the prostate. At this time, radical prostatectomy may cure prostate cancer and prevent further progression of the disease and the risk of eventual death.